scholarly journals A remote and immersive setup for pandemic-safe surgical education

2021 ◽  
Vol 7 (2) ◽  
pp. 456-459
Author(s):  
Jean-Claude Rosenthal ◽  
Armin Schneider ◽  
Eric L. Wisotzky ◽  
Senna Meij ◽  
John van den Dobbelsteen ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Surgical Training ◽  
Surgical Education ◽  
Anatomical Landmarks ◽  
Remote Locations ◽  
Modular Software ◽  
Surgical Assistance ◽  
Spectral Algorithm ◽  
Technological Developments ◽  
Interactive Annotation

Abstract Existing challenges in surgical education (See one, do one, teach one) as well as the Covid-19 pandemic make it necessary to develop new ways for surgical training. This is also crucial for the dissemination of new technological developments. As today’s live transmissions of surgeries to remote locations always come with high information loss, e.g. stereoscopic depth perception, and limited communication channels. This work describes the implementation of a scalable remote solution for surgical training, called TeleSTAR (Telepresence for Surgical Assistance and Training using Augmented Reality), using immersive, interactive and augmented reality elements with a bi-lateral audio pipeline to foster direct communication. The system uses a full digital surgical microscope with a modular software-based AR interface, which consists of an interactive annotation mode to mark anatomical landmarks using an integrated touch panel as well as an intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics.We broadcasted three cochlea implant surgeries in the context of otorhinolaryngology. The intervention scaled to five different remote locations in Germany and the Netherlands with lowlatency. In total, more than 150 persons could be reached and included an evaluation of a participant’s questionnaire indicating that annotated AR-based 3D live transmissions add an extra level of surgical transparency and improve the learning outcome.

scholarly journals Augmented Reality in Orthopedic Surgery Is Emerging from Proof of Concept Towards Clinical Studies: a Literature Review Explaining the Technology and Current State of the Art

2021 ◽  
Author(s):  
Fabio A. Casari ◽  
Nassir Navab ◽  
Laura A. Hruby ◽  
Philipp Kriechling ◽  
Ricardo Nakamura ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Orthopedic Surgery ◽  
Relevant Literature ◽  
Comprehensive Overview ◽  
Basic Principles ◽  
Clinical Procedures ◽  
Current State ◽  
Tremendous Progress ◽  
Orthopedic Oncology ◽  
Technological Developments

Abstract Purpose of Review Augmented reality (AR) is becoming increasingly popular in modern-day medicine. Computer-driven tools are progressively integrated into clinical and surgical procedures. The purpose of this review was to provide a comprehensive overview of the current technology and its challenges based on recent literature mainly focusing on clinical, cadaver, and innovative sawbone studies in the field of orthopedic surgery. The most relevant literature was selected according to clinical and innovational relevance and is summarized. Recent Findings Augmented reality applications in orthopedic surgery are increasingly reported. In this review, we summarize basic principles of AR including data preparation, visualization, and registration/tracking and present recently published clinical applications in the area of spine, osteotomies, arthroplasty, trauma, and orthopedic oncology. Higher accuracy in surgical execution, reduction of radiation exposure, and decreased surgery time are major findings presented in the literature. Summary In light of the tremendous progress of technological developments in modern-day medicine and emerging numbers of research groups working on the implementation of AR in routine clinical procedures, we expect the AR technology soon to be implemented as standard devices in orthopedic surgery.

scholarly journals Laparoscopic augmented reality registration for oncological resection site repair

2021 ◽  
Author(s):  
Fabian Joeres ◽  
Tonia Mielke ◽  
Christian Hansen
Keyword(s):  
Augmented Reality ◽  
Time Pressure ◽  
Tumour Resection ◽  
Anatomical Landmarks ◽  
Proof Of Concept ◽  
Registration Accuracy ◽  
Target Registration Error ◽  
Concept Evaluation ◽  
Navigation Support ◽  
Challenges And Opportunities

Abstract Purpose Resection site repair during laparoscopic oncological surgery (e.g. laparoscopic partial nephrectomy) poses some unique challenges and opportunities for augmented reality (AR) navigation support. This work introduces an AR registration workflow that addresses the time pressure that is present during resection site repair. Methods We propose a two-step registration process: the AR content is registered as accurately as possible prior to the tumour resection (the primary registration). This accurate registration is used to apply artificial fiducials to the physical organ and the virtual model. After the resection, these fiducials can be used for rapid re-registration (the secondary registration). We tested this pipeline in a simulated-use study with $$N=18$$ N = 18 participants. We compared the registration accuracy and speed for our method and for landmark-based registration as a reference. Results Acquisition of and, thereby, registration with the artificial fiducials were significantly faster than the initial use of anatomical landmarks. Our method also had a trend to be more accurate in cases in which the primary registration was successful. The accuracy loss between the elaborate primary registration and the rapid secondary registration could be quantified with a mean target registration error increase of 2.35 mm. Conclusion This work introduces a registration pipeline for AR navigation support during laparoscopic resection site repair and provides a successful proof-of-concept evaluation thereof. Our results indicate that the concept is better suited than landmark-based registration during this phase, but further work is required to demonstrate clinical suitability and applicability.

scholarly journals Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education

2019 ◽  
Vol 4 ◽  
pp. 187
Author(s):  
William Dean ◽  
Stephen Gichuhi ◽  
John Buchan ◽  
Ibrahim Matende ◽  
Ronnie Graham ◽  
...  
Keyword(s):  
Surgical Training ◽  
Southern Africa ◽  
Surgical Education ◽  
Training Programme ◽  
Sub Saharan Africa ◽  
African Region ◽  
Cross Sectional Survey ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Recent Graduates

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as ‘somewhat satisfied’ or ‘very satisfied’ by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

Digital Twin: Collaborative Virtual Reality Environment for Multi-Purpose Industrial Applications

2020 ◽  
Author(s):  
Vladimir Kuts ◽  
Tauno Otto ◽  
Yevhen Bondarenko ◽  
Fei Yu
Keyword(s):  
Virtual Reality ◽  
Augmented Reality ◽  
Mobile Robot ◽  
Industrial Robots ◽  
Use Cases ◽  
System Level ◽  
Manufacturing Processes ◽  
Remote Locations ◽  
System Level Simulation ◽  
Smart Healthcare

Abstract Industrial Digital Twins (DT) is the precise virtual representation of the manufacturing environment and mainly consists of the system-level simulation, which combines both manufacturing processes and parametric models of the product. As being one of the pillars of the Industry 4.0 paradigm, DT-s are widely integrated into the existing factories, enhancing the concept of the virtual factories. View from the research perspective is that experiments on the Internet of Things, data acquisition, cybersecurity, telemetry synchronization with physical factories, etc. are being executed in those virtual simulations. Moreover, new ways of interactions and interface to oversee, interact and learn are being developed via the assistance of Virtual Reality (VR) and Augmented Reality (AR) technologies, which are already widely spread on the consumer market. However, already, VR is being used widely in existing commercial software packages and toolboxes to provide students, teachers, operators, engineers, production managers, and researchers with an immersive way of interacting with the factory while the manufacturing simulation is running. This gives a better understanding and more in-depth knowledge of the actual manufacturing processes, not being directly accessing those. However, the virtual presence mentioned above experience is limited to a single person. It does not enable additional functionalities for the simulations, which can be re-planning or even re-programming of the physical factory in an online connection by using VR or AR interfaces. The main aim of the related research paper is to enhance already existing fully synchronized with physical world DT-s with multi-user experience, enabling factory operators to work with and re-program the real machinery from remote locations in a more intuitive way instead thinking about final aim than about the process itself. Moreover, being developed using real-time platform Unity3D, this multiplayer solution gives opportunities for training and educational purposes and is connecting people from remote locations of the world. Use-cases exploits industrial robots placed in the Industrial Virtual and Augmented Reality Laboratory environment of Tallinn University of Technology and a mobile robot solution developed based on a collaboration between the University of Southern Denmark and a Danish company. Experiments are being performed on the connection between Estonia and Denmark while performing reprogramming tasks of the physical heavy industrial robots. Furthermore, the mobile robot solution is demonstrated in a virtual warehouse environment. Developed methods and environments together with the collected data will enable us to widen the use-cases with non-manufacturing scenarios, i.e., smart city and smart healthcare domains, for the creation of a set of new interfaces and multiplayer experiences.

The future surgical training paradigm: Virtual reality and machine learning in surgical education

Surgery ◽  
2020 ◽  
Author(s):  
Michael P. Rogers ◽  
Anthony J. DeSantis ◽  
Haroon Janjua ◽  
Tara M. Barry ◽  
Paul C. Kuo
Keyword(s):  
Machine Learning ◽  
Virtual Reality ◽  
Surgical Training ◽  
Surgical Education ◽  
Training Paradigm ◽  
The Future

Surgical assistance - who can help?

2014 ◽  
Vol 96 (7) ◽  
pp. 244-246 ◽  
Author(s):  
Susan Hall ◽  
Julie Quick ◽  
Andrew Hall ◽  
Adrian Jones
Keyword(s):  
Patient Care ◽  
Surgical Training ◽  
Perioperative Care ◽  
Working Time ◽  
European Working Time Directive ◽  
Surgical Assistance ◽  
European Working ◽  
High Standards ◽  
Working Time Directive

Changes affecting surgical training, together with the implementation of the European Working Time Directive, have necessitated increased reliance on non-medically qualified assistants. Such assistance must be performed by suitably educated personnel. The RCS, The Perioperative Care Collaborative (PCC) and The Association for Perioperative Practice (AfPP) all play a role in ensuring high standards of patient care. In so doing, they have determined the circumstances and the level at which such assistance may be given by three grades of perioperative personnel. It is essential that surgeons understand and support such non-medically qualified colleagues in adhering to these standards.

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